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Montana rates for HCPCS A9500

Technetium Tc-99m sestamibi, diagnostic, per study dose

Facilitymedian $195 · 10th–90th $40–$1,2590%10%20%10th90th$195Professionalmedian $204 · 10th–90th $102–$5130%20%10th90th$204$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $151.36 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $204.17 / $776.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $64,565.42 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $281.84 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $177.83
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $194.98 / $194.98
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $194.98 / $194.98
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $281.84 / $724.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $114.82 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68